How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,023 to $12,882Professionalmedian $832 · 10th to 90th $117 to $1,349
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $11,481.54 | Facility | None | $707.95 | $4,073.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,230.27 | Professional | None | $870.96 | $933.25 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $1,995.26 Typical High $9,549.93 | Facility | None | $512.86 | $1,995.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,202.26 | Professional | None | $794.33 | $1,047.13 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,187.76 Typical High $3,890.45 | Facility | None | $436.52 | $2,187.76 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,659.59 | Professional | None | $758.58 | $812.83 | $1,659.59 |
Florida Blue Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,288.25 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $436.52 Median $912.01 Typical High $1,071.52 | Professional | None | $436.52 | $912.01 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $758.58 Typical High $1,230.27 | Professional | None | $87.10 | $758.58 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,778.28 | Professional | None | $707.95 | $912.01 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | None | $741.31 | $741.31 | $977.24 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $602.56 | Professional | 52 · Reduced service | $436.52 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $239.88 | Professional | 53 · Discontinued | $173.78 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $891.25 | Professional | 54 · Surgery only | $645.65 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $181.97 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $831.76 |
Where Florida sits
The same service costs 5.3 times more in Vermont than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
VT $13,652HI $2,577
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.